Methods of reducing surgical complications in cancer patients

CROSS-REFERENCE TO RELATED APPLICATION

0001This application claims the benefit of U.S. Provisional Application No. 60/917,434 filed May 11, 2007, the disclosure of which is incorporated herein by reference.

BACKGROUND

0002The present disclosure relates to the administration of therapeutic compositions to cancer surgical sites for the prevention and/or reduction of surgical complications incident to concomitant radiation therapy.

0003Radiation therapy is a mainstay treatment for cancer, and is used in treating approximately 70% of cancer patients. The therapy itself is responsible for about 40% of cancer cures and is commonly combined with other treatment methods including surgery, chemotherapy and immunotherapy. Nevertheless, radiation induces profound changes in skin and subcutaneous tissues. In general, the severity of radiation induced tissue damage depends on the site of radiation treatment, the type and energy of the radiation dose, and the time-dose volume relationship. These side effects can have particular clinical significance in treatments that involve both radiation and surgery, potentially interfering with healing at the surgical site. Accordingly, therapies that prevent or reduce the side effects of radiation therapy, particularly for surgical candidates or patients, are highly desirable.

SUMMARY

0004The present technology provides methods for treating irradiated tissue in a human or other animal subject. Included are methods for revascularization and preventing or reducing wound healing complications in a subject having cancer, wherein the subject has an irradiated site and has or will optionally be treated surgically. Complications can include, for example, prolonged wound drainage, hematomas, seromas, fistula formation infection, pain, tissue fibrotic tissue formation, poor coloration, deficient vascularity, and desensitization in the surgical site. Methods comprise administering a blood component to the irradiated site, within a time period after irradiation. Blood components include platelet rich plasma, platelet poor plasma and platelet concentrate.

0005Further areas of applicability will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.

DRAWINGS

The present technology will become more fully understood from the detailed description and the accompanying drawings, wherein:

<figref idref="DRAWINGS">FIG. 1</figref> illustrates a representative site of a tissue defect on a subject in need of treatment according to one embodiment of the present technology;

<figref idref="DRAWINGS">FIG. 2</figref> is a diagrammatic illustration of a representative method for treating irradiated tissue according to one embodiment of the present technology;

<figref idref="DRAWINGS">FIG. 3</figref> is a cross-sectional view of a representative device used for isolating a blood component according to one embodiment of the present technology;

<figref idref="DRAWINGS">FIGS. 4A and 4B</figref> are cross-sectional views of a representative device used for concentrating a blood component according to one embodiment of the present technology; and

<figref idref="DRAWINGS">FIG. 5</figref> illustrates a representative manner of administering a therapeutic composition to a subject according to one embodiment of the present technology.

DETAILED DESCRIPTION

0012The following description of technology is merely exemplary in nature of the subject matter, manufacture, and use of one or more inventions, and is not intended to limit the scope, application, or uses of any specific invention claimed in this application or in such other applications as may be filed claiming priority to this application, or patents issuing therefrom.

0013<figref idref="DRAWINGS">FIG. 1</figref> illustrates irradiated tissue <b>39</b>, in a surgical site <b>10</b> in a limb of a human patient having a cancer. It should be understood, however, that such tissue can be at any place on the body of a cancer patient who has received radiation therapy, and that such therapy may be performed without surgery, or before or after surgery. As discussed further below, a surgical site comprises any breach of skin and can include any incision or wound involving hard or soft tissue, such as skin, fascia, muscle, viscera, organs or bone. The surgical site can comprise the site of dissection of skin, cutaneous tissue, muscle and other tissues to expose a tumor to be removed, and can include a site where a tumor has been removed and tissue is repaired or reconstructed that is cosmetically or physiologically inadequate incident to a cancerous tumor. For example, as shown in <figref idref="DRAWINGS">FIG. 1</figref>, a surgical site <b>10</b> can include an incision of skin <b>20</b>, connective tissues (superficial fascia tissue <b>30</b>), and tissue <b>39</b> (e.g., muscle tissue) which has been irradiated in a method of this technology.

0014One general method for treating irradiated tissue in a human or other animal subject is shown in <figref idref="DRAWINGS">FIG. 2</figref>. In summary, a tumor site is identified containing cancerous cells or tissue at step <b>100</b>. Tissue comprising the cancerous tissue is then irradiated at step <b>180</b>. After a waiting period <b>150</b>, a blood component is obtained at step <b>140</b>. Optional materials may be added to the blood component at step <b>160</b>. The blood component is then applied to the irradiated tissue at step <b>200</b>. The methods may comprise several optional steps. For example, cancerous tissue may be removed by surgery at step <b>170</b>. Such surgery may be performed before or after (or both) the irradiation step <b>180</b>. One or more chemotherapeutic agents may also be administered to the subject in step <b>190</b> before, after, or during any or all of steps <b>170</b>, <b>180</b>, <b>150</b>, and <b>200</b>. Moreover, the radiation step <b>180</b> and administration of chemotherapeutic agent step <b>190</b> may be repeated two or more times.

0015As generally discussed above, a site containing cancerous tissue is identified at step <b>100</b>. Such cancerous tissue can occur anywhere in the subject. Examples include tumors in breast, head and neck tissues. Identifying the tumor site can be achieved using any medically acceptable procedure including invasive and non-invasive screening techniques. Invasive screening techniques used to identify a tumor site can include tissue biopsy, laparotomy and laparoscopy. Non-invasive screening techniques include manual examination, palpitation, computer tomography scanning (CT scanning), magnetic resonance imaging (MRI), and x-rays.

0016Referring to <figref idref="DRAWINGS">FIG. 2</figref>, radiation is applied to tissue comprising the tumor site in the irradiation step <b>180</b>. The form of the irradiation procedure can include focused tissue irradiation, steriotactic irradiation, whole beam irradiation, and brachytherapy. The specific radiation type, level, and dosage regimen is determined according to the type, size and location of cancer to be treated and general health of the subject, pursuant to sound medical practice.

0017As further depicted in <figref idref="DRAWINGS">FIG. 2</figref>, a blood component is obtained at step <b>140</b> and applied to irradiated tissue at step <b>200</b>. Preferably, however, there is a waiting period <b>150</b> prior to applying the blood component in step <b>200</b>. The timing of the waiting period step <b>150</b> after irradiation step <b>180</b> may affect the wound healing process and the repair of the irradiated tissue. In some embodiments, the waiting period <b>150</b> after the irradiation step <b>180</b> may be as short as 3 weeks, In some embodiments, for example for head and neck tumors, a suitable waiting period can include 1 month to 7 months before subsequent treatment with blood components of step <b>200</b>. In breast cancers, a waiting period can be shorter, for example 1 month to 5 months before subsequent application of blood components in step <b>200</b>.

0018As discussed above, a blood component is obtained at step <b>140</b>. The blood component may be obtained from blood from the subject to be treated, or from another human or animal donor identified as being compatible with the subject. The blood component may comprise fractionated plasma in the form of platelet-rich plasma, platelet-poor plasma, or concentrated platelet-poor plasma. In this regard, a blood component comprising platelet-rich plasma may have an increased concentration of platelets relative to whole blood, and in some embodiments, the platelet concentration can be from about 3-fold to about 10-fold greater than the platelet concentration in whole blood. A blood component comprising platelet-poor plasma may have a decreased concentration of platelets relative to whole blood, and in some embodiments, the platelet concentration can be from about 0 to about 100,000 platelets/mL. The platelet-poor plasma can also be concentrated to make concentrated platelet-poor plasma. Further, the isolated tissue composition obtained at step <b>140</b> may have varying mixtures of platelet-rich plasma and platelet-poor plasma, or isolated platelets resuspended with platelet-poor plasma or concentrated platelet-poor plasma, resulting in a range of platelet concentrations.

0019A blood component can be obtained at step <b>140</b> by one or more methods, including filtration, cryoprecipitation, and density fractionation. Density fractionation techniques include single stage centrifugation, centrifugation in multiple stages, and continuous flow centrifugation.

0020One example of a device that may be used for forming the blood component by density fractionation at step <b>140</b> is shown in <figref idref="DRAWINGS">FIG. 3</figref>. In this regard, the device <b>220</b> includes a container <b>240</b>, such as a tube, that is placed in a centrifuge after being filled with blood. The container <b>240</b> includes a buoy system having an isolator <b>260</b> and a buoy <b>280</b>. The buoy <b>280</b> has a selected density, which is tuned to reach a selected equilibrium position upon centrifugation; this position lies between a more dense blood fraction and a less dense blood fraction. During centrifugation, the buoy <b>280</b> separates the blood within the container <b>240</b> into at least two fractions, without substantially commingling the fractions, by sedimenting to a position between the two fractions. In this regard, the isolator <b>260</b> and the buoy <b>280</b> define a layer comprising platelet-rich plasma <b>300</b>, while less dense platelet-poor plasma <b>320</b> generally fractionates above the isolator <b>260</b>, and more dense red blood cells <b>340</b> generally fractionate below the buoy <b>280</b>. Following centrifugation, a syringe or tube may then be interconnected with a portion of the buoy system to extract one or more selected fractions for use as the blood component. Devices including those disclosed in <figref idref="DRAWINGS">FIG. 3</figref> and associated methods are described in U.S. Patent Application Publication 2004/0251217, Leach et al., published Dec. 16, 2004; and U.S. Patent Application Publication 2005/0109716, Leach et al., published May 26, 2005; both of which are incorporated by reference herein. One such device that is commercially available is the GPS™ Platelet Concentrate System, from Biomet Biologics, Inc. (Warsaw, Ind.).

0021Another example of a device that may be used in step <b>140</b> to isolate platelet-rich plasma by density fractionation comprises a centrifugal drum separator and an erythrocyte capture trap. In one embodiment, the walls of the centrifugal drum separator are coated with a depth filter having pores and passageways that are sized to receive and entrap erythrocytes. Blood is placed in the centrifugal drum, and the drum is spun along its axis at sufficient speed so as to force erythrocytes from the blood into the depth filter. After spinning, the erythrocytes remain in the filter and the remaining platelet-rich plasma is extracted. The platelet-rich plasma may be concentrated by desiccation. Such concentration devices include the VORTECH® Concentration System (Biomet Biologics, Inc., Warsaw, Ind.), and are disclosed in U.S. Patent Application Publication 2006/0175244, Dorian et al., published Aug. 10, 2006; and U.S. Patent Application Publication 2006/0175242, Dorian et al., published Aug. 10, 2006; both of which are hereby incorporated by reference. Such devices may be used to prepare platelet-rich plasma in lieu of or in addition to using the tube having a buoy that is described above and shown in <figref idref="DRAWINGS">FIG. 3</figref>.

0022A concentrated blood component, such as concentrated platelet-poor plasma, may also be obtained at step <b>140</b>. Platelet-poor plasma can be obtained, for example, using a device illustrated in <figref idref="DRAWINGS">FIG. 3</figref>, as described above. The platelet-poor plasma is then concentrated using any of a variety of concentration methods, including those known in the art for reducing the water content of the plasma. One example of a device that may be used for forming concentrated platelet-poor plasma at step <b>140</b> is shown in <figref idref="DRAWINGS">FIGS. 4A and 4B</figref>. In this regard, the device <b>400</b> has an upper chamber <b>410</b> and a lower chamber <b>420</b>. The upper chamber <b>410</b> has an end wall <b>430</b> through which the agitator stem <b>440</b> of a gel bead agitator <b>450</b> extends. The device <b>400</b> also has a plasma inlet port <b>460</b> that extends through the end wall <b>43</b> and into the upper chamber <b>410</b>. The device <b>400</b> also includes a plasma concentrate outlet port <b>470</b> that communicates with a plasma concentrate conduit <b>480</b>. The floor of upper chamber <b>410</b> includes a filter <b>490</b>, the upper surface of which supports desiccated concentrating polyacrylamide beads <b>500</b>.

0023During use, blood plasma <b>520</b> (preferably cell free) is initially introduced into the upper chamber <b>410</b> through the plasma inlet port <b>460</b>. The blood plasma <b>520</b> entering the upper chamber <b>410</b> flows to the bottom of the chamber where it contacts the polyacrylamide beads <b>500</b> as shown in <figref idref="DRAWINGS">FIG. 4A</figref>. As the polyacrylamide beads <b>500</b> remove water from blood plasma <b>520</b>, the plasma proteins are concentrated. During this concentration stage, the plasma and its components can be concentrated to a concentration from about 1.5 to about 3 times or higher than its original concentration.

0024Referring to <figref idref="DRAWINGS">FIG. 4B</figref>, the device <b>400</b> is then placed in the cup receptors of a conventional laboratory centrifuge (not shown) and spun at a speed that will create a centrifugal force that will remove plasma concentrate <b>530</b> from the polyacrylamide beads <b>500</b>, and cause the plasma concentrate <b>530</b> to flow through the filter <b>490</b>. The filter <b>490</b> can be constructed to allow flow of liquid there through at centrifugal forces above 10×g. After centrifugation is completed, the device <b>400</b> is removed from the centrifuge. The plasma concentrate <b>530</b> is then drawn from lower chamber <b>420</b> through plasma concentrate conduit <b>480</b> to the plasma concentrate outlet port <b>470</b>.

0025Exemplary plasma concentration devices useful in step <b>140</b> are disclosed in U.S. Patent Application Publication 2006/0175268, Dorian et al., published Aug. 10, 2006; and U.S. Patent Application Publication 2006/0243676, Swift et al., published Nov. 2, 2006; both of which are incorporated by reference herein. Such a plasma concertration device is commercially available as PLASMAX® Plus Plasma Concentrator, from Biomet Biologics, Inc. (Warsaw, Ind.).

0026Other devices that may be used to obtain the isolated tissue composition at step <b>140</b> are described, for example, in U.S. Pat. No. 6,398,972, Blasetti et al., issued Jun. 4, 2002; U.S. Pat. No. 6,649,072, Brandt et al., issued Nov. 18, 2003; U.S. Pat. No. 6,790,371, Dolecek, issued Sep. 14, 2004; and U.S. Pat. No. 7,011,852, Sukavaneshvar et al., issued Mar. 14, 2006; and U.S. Patent Application Publication 2005/0196874, Dorian et al., published Sep. 8, 2005. In addition to the concentration devices GPS® Platelet Concentrate System and VORTECH® Concentration System, other commercially available devices that may be used to obtain the isolated tissue composition at step <b>14</b> include the platelet seperation devices MEGELLAN® Autologous Platelet Separator System, commercially available from Medtronic, Inc. (Minneapolis, Minn.); SMARTPREP®, Platelet Concentrate System, commercially available from Harvest Technologies Corporation (Plymouth, Mass.) and DePuy Spine, Inc. (Warsaw, Ind.); the AUTOLOGEL™ Process, commercially available from Cytomedix (Rockville, Md.), and the GENESISCS™ component concentrating system, available from EmCyte Corporation (Fort Myers, Fla.).

0027The blood component obtained in step <b>140</b> may be combined with one or more optional materials in step <b>160</b>. Such optional materials include, for example, platelet activators, scaffolds, bioactive materials, cytokines, and combinations thereof. The optional materials can be applied in step <b>160</b> just prior to the administration of the blood component in step <b>200</b>. Alternatively, the optional materials may be applied in step <b>160</b> concomitant with administration of the blood component in step <b>200</b>, or following administration of the blood component to the surgical site in step <b>200</b>.

0028Platelet activators may be added in step <b>160</b> so as to activate one or more growth factors within platelets contained in an isolated tissue composition. In this regard, the platelet activator may serve to activate one or more growth factors within platelets contained in the blood component. Activation of the platelets by the platelet activators can be performed just prior to administration of the blood component, concomitant with administration of the blood component, or following administration of the blood component to the site. Platelet activators among those useful herein include thrombin, including autologous thrombin, calcium chloride (CaCl₂), and mixtures thereof. In some embodiments, coagulation factors can be used to activate platelets. Coagulation factors include, but are not limited to, one or more of the following: V, VII, VIIa, IX, IXaβ, X, Xa, XI, XIa, XII, α-XIIa, β-XIIa, and XIII. Various embodiments can include one or more coagulation factors, including autologous coagulation factors, and/or thrombin, and/or CaCl₂.

0029A scaffold may be added in step <b>160</b> to contain, support, or retain the blood component at the surgical site, or to facilitate migration of endogenous cells into the surgical site. Scaffolds may be formed from porous or semi-porous, natural, synthetic or semisynthetic materials. Scaffold materials include those selected from the group consisting of bone (including cortical and cancellous bone), demineralized bone, ceramics, polymers, and combinations thereof. Bone, demineralized bone and ceramics may be particularly useful in methods where the blood component is applied to bone. Suitable polymers may include collagen, including lyophilized or skin-derived collagen as disclosed in U.S. Application Publication No. 2007/0092494, Higgins, published Apr. 26, 2007, which is incorporated by reference herein. Polymers may also include gelatin, hyaluronic acid, chitosan, polyglycolic acid, polylactic acid, polypropylenefumarate, polyethylene glycol, and copolymers or combinations thereof. Ceramics include any of a variety of ceramic materials known in the art for use for implanting in bone, such as calcium phosphate (including tricalcium phosphate, tetracalcium phosphate, hydroxyapatite, and mixtures thereof). Ceramics useful herein include those described in U.S. Pat. No. 6,323,146, Pugh et al., issued Nov. 27, 2001; and U.S. Pat. No. 6,585,992, Pugh et al., issued Jul. 1, 2003; both of which are incorporated by reference herein. A commercially available bone implant ceramic is PROOSTEON® from Interpore Cross International, Inc. (Irvine, Calif.).

0030In some embodiments, step <b>160</b> may also include the addition of one or more bioactive materials that provide a therapeutic, nutritional or cosmetic benefit to the subject in which implants are applied. Such benefits may include repairing unhealthy or damaged tissue, minimizing infection at the surgical site, increasing integration of healthy tissue into the surgical site, and preventing disease or defects in healthy or damaged tissue.

0031Bioactive materials that may be included in step <b>160</b> include organic molecules, proteins, peptides, peptidomimetics, nucleic acids, nucleoproteins, antisense molecules, polysaccharides, glycoproteins, lipoproteins, carbohydrates, and polysaccharides; synthetic and biologically engineered analogs thereof; living cells such as chondrocytes, bone marrow cells, stem cells, viruses and virus particles, natural extracts, and stromal cells; and combinations thereof. Specific non-limiting examples of bioactive materials include cytokines, hormones, antibiotics and other anti-infective agents, hematopoietics, thrombopoietics agents, antiviral agents, antitumoral agents (chemotherapeutic agents), antipyretics, analgesics, anti-inflammatory agents, enzymes, vaccines, immunological agents and adjuvants, cytokines, growth factors, cellular attractants and attachment agents, gene regulators, vitamins, minerals and other nutritionals, platelet activators, and combinations thereof. Bioactive agents may be included that have effects at sites not proximate to the surgical site, such as (in addition to agents listed above) hematopoietics, thrombopoietics, antidementia agents, antiallergic agents, antidepressants, psychotropic agents, anti-parkinsonian agents, therapeutic agents for osteoporosis, cardiotonics, antiarrythmic agents, vasodilators, antihypertensive agents, diuretics, anti-cholinergic, antidiabetic agents, cholesterol lowering agents, gastrointestinal agents, muscle relaxants, and combinations thereof.

0032Step <b>160</b> may also include the addition of one or more cytokines, including isolated, synthetic or recombinant molecules. Cytokines useful herein include growth factors such as transforming growth factor (TGF-beta), bone morphogenic proteins (BMP, BMP-2, BMP-4, BMP-6, and BMP-7), neurotrophins (NGF, BDNF, and NT3), fibroblast growth factor (FGF), granulocyte-colony stimulating factor (G-CSF), granulocyte-macrophage colony stimulating factor (GM-CSF), nerve growth factor (NGF), neurotrophins, platelet-derived growth factor (PDGF), erythropoietin (EPO), thrombopoietin (TPO), myostatin (GDF-8), growth differentiation factor-9 (GDF9), basic fibroblast growth factor (bFGF or FGF2), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), insulin-like growth factors (IGF-I, IFG-II), and combinations thereof. Cytokines can be applied to the site just prior to the administration of the therapeutic composition, concomitant with administration of the therapeutic composition, or following administration of the therapeutic composition to the subject.

0033Stem cells, such as bone marrow-derived stem cells and adipose-derived stromal cells, may also be added to the blood component in step <b>160</b>. Adipose-derived stromal cells may be obtained from processing of lipid tissue by standard liposuction and lipoaspiration methods known in the art. Adipose tissue may be treated with digestive enzymes and with chelating agents that weaken the connections between neighboring cells, making it possible to disperse the tissue into a suspension of individual cells without appreciable cell breakage. Following disaggregation, the adipose stromal cells may be isolated from the suspension of cells and disaggregated tissue. A device as shown in <figref idref="DRAWINGS">FIG. 3</figref>, such as the GPS™ Platelet Concentrate System, may be used to isolate adipose stromal cells.

0034Referring again to <figref idref="DRAWINGS">FIG. 2</figref>, the blood component obtained at step <b>140</b> is administered to the irradiated site at step <b>200</b>. For example, the blood component obtained in step <b>140</b> can be sprayed onto the irradiated tissue <b>39</b> using an applicator <b>50</b>, as shown in <figref idref="DRAWINGS">FIG. 5</figref>. The blood component may be administered using any medically acceptable process or procedure by which the blood component is implanted, injected, sprayed, applied, or otherwise administered in, on, or in proximity to the site of the irradiated site so as prevent or reduce surgical complications, for example fibrotic tissue formation. Methods of treating an irradiated site may include applying the blood component to an irradiated site to facilitate or enhance the rate of healing and/or provide for more complete healing, prevent wound healing complications, or reduce the number and severity of surgical complications. For example, the blood component may be effective in preventing or reducing wound healing complications in cancer patients after irradiation of the tumor site by inducing homeostasis, stimulating soft tissue and bone healing, enhancing skin graft adherence, increasing bone graft union, increasing antimicrobial effects, and promoting angiogenesis and vascularity in the irradiated site.

0035Administration of the blood component in step <b>200</b> can comprise single or multiple applications in a regular or irregular pattern in and surrounding the site of the irradiation. As shown in <figref idref="DRAWINGS">FIG. 5</figref>, a combination of platelet-rich plasma in a first syringe <b>60</b> may be admixed with platelet-poor plasma and thrombin in a second syringe <b>70</b> upon application into the irradiated tissue <b>39</b>. For example, the mixture <b>80</b> is sprayed on to the surface of the tissues within a surgical site <b>10</b> exposed by retractors <b>35</b> after a tumor has been removed.

0036In some embodiments, solid support including a membrane, a cloth, a tampon, or gauze can be implanted into the irradiated site and co administered with the blood component in step <b>200</b>. In some embodiments, the solid support can be coated or imbibed with the therapeutic composition before implantation into the irradiated site.

0037Step <b>200</b> may also include the application of a fibrin sealant or glue into the irradiated site revascularize damaged blood vessels and/or prevent the formation of fibrotic tissue at the irradiated site. In various embodiments, the blood component can include platelet poor plasma that is naturally enriched with fibrinogen. In some embodiments, the administration of the blood component in step <b>200</b> can be accomplished by injecting the blood component into the irradiated site. With reference to <figref idref="DRAWINGS">FIG. 5</figref>, in some embodiments, an applicator <b>50</b> may combine platelet rich plasma contained in a first syringe <b>60</b> and mixture of CaCl and platelet poor plasma in a second syringe <b>70</b>. In some embodiments, the platelet poor plasma in the second syringe <b>70</b> is also admixed with thrombin and applied through the applicator <b>50</b>. The amount of fibrin glue can be tailored to the status of the irradiated site. In some embodiments, when there is a high degree of bleeding in the irradiated site, for example after cancerous tissue removal of step <b>170</b>, the therapeutic composition can contain a higher percentage of platelet poor plasma or platelet poor plasma concentrate and thrombin to assist in hemostasis. Where there is a significant amount of blood or other fluid at the site, the fluid will activate the interaction of fibrinogen and thrombin. Fibrin glues can be particularly useful where other suturing techniques, such as stitching or stapling, are unsuitable. They can be placed directly into the irradiated site, and are fully reabsorbed into the body.

0038Referring again to <figref idref="DRAWINGS">FIG. 2</figref>, surgical removal of cancerous tissue is optionally performed in step <b>170</b>. Such surgery may be performed at one or more times throughout the treatment process, and may be before or after the irradiation step <b>180</b>. Surgical procedures include any diagnostic, or curative procedure during which an incision is made in soft or hard tissue.

0039Curative surgery is typically performed when a tumor appears to be confined to one area and it is likely that all of the tumor can be removed. Curative surgery can be the primary treatment of the cancer. In the removal of certain soft tissue sarcomas, the tumor mass is excised and replacement of tissue is done by implanting an autologous region of compatible tissue, such as muscle and/or a myocutaneous tissue flap. Debulking surgery may be performed to remove a portion of a tumor when removing the entire tumor would cause too much damage to an organ or near-by tissues. In these cases, the surgeon may remove as much of the tumor as possible and then treat the remaining tumor with radiation therapy and/or chemotherapy. Palliative surgery may be performed to treat complications of advanced cancer. Rather than curing the cancer, palliative surgery may correct a problem that is causing discomfort or disability. For example, some cancers in the abdomen may grow large enough to obstruct (block off) the intestine. This may require surgery to remove the blockage. Palliative surgery may also be used to treat pain when it is hard to control it by other means. Supportive surgery may also be performed to augment other types of treatment. For example, a vascular access device such as a catheter port can be surgically placed into a large vein. The port can then be used to give chemotherapy treatments or draw blood for testing, reducing the number of needle sticks needed. Other supportive surgeries can include ligament and tendon repair when removal of primary tumor mass necessitates removal of healthy tissue. Occasionally, the patient may also require a surgical procedure necessitated for reasons unrelated to the tumor itself.

0040In some methods, the cancerous tissue in the neck area is ressected using surgical procedures, such as salvage neck dissection, radical neck dissection, dissection of the oropharynx, salvage neck dissection, modified radical neck dissection, extended radical neck dissection, elective neck dissections, supraomohyoid neck dissection, anterior compartment neck dissection, posterolateral neck dissection, lateral neck dissection.

0041Chemotherapy may also be performed, in step <b>190</b>. Chemotherapy may employ topical or systemic administration of one or more antineoplastic agents including those well known in the art. The specific selection and dosage regimen for such agents is determined according to the type and location of cancer treated and the general health of the subject pursuant to sound medical practice. The chemotherapy administration step <b>190</b> can be performed before, after, or during any or all of steps <b>150</b>, <b>170</b>, <b>180</b>, and <b>200</b>.

0042As mentioned above, the present technology also provides methods for reducing one or more complications of tissue irradiation. Such complications include fistulas, fibrosis, seromas, hematomas, infections, discoloration of the skin, wound pain, wound dehiscence, wound breakout, fibrotic tissue formation and necrosis in and around the irradiated site and other areas affected by the irradiation. The severity of the complications can be measured quantitatively and qualitatively, for example, the length of stay in the hospital, the amount of wound drainage produced, reduction in the elasticity of the tissue around the surgical site, degree of scar formation, degree of tissue adhesion between the incision site or between donor tissue implanted in the surgical bed and surrounding treated tissue, vascular deficiency and loss of sensitization around the surgical site.

0043The following non-limiting example illustrates the materials, methods, and processes of the present technology. The example is provided for illustrative purposes of how to make and use the materials and methods of this technology and is not intended to be a representation that given embodiments of this technology have, or have not, been performed or tested.

EXAMPLE

0044A method of the present technology is performed on a human subject undergoing salvage neck dissection for cervical metastases. Patients undergoing such salvage neck dissections are generally a higher risk for surgical complications including neck fibrosis, prolonged wound drainage, and poor tissue adhesion resulting in delayed wound healing. In the method, blood is obtained from the subject and placed in a centrifuge tube as depicted in <figref idref="DRAWINGS">FIG. 3</figref>, and spun in a GPS™ Platelet Concentrate System, from Biomet Biologics, Inc. (Warsaw, Ind.). A blood component comprising platelet-rich plasma is obtained, and applied to the surgical bed. A drain with a 2-layer closure was implanted during the procedure, to allow wound drainage.

0045Post-operatively, the drainage from the surgical site is measured to be about 264 ml, which is observed to be less than the drainage from the surgical sites of similar subjects who are not treated with a method of the present technology. The subject is released from the hospital in about 3 days, which is less than the hospital stay from similar subjects who are not treated with a method of the present technology. Neck skin fibrosis is also measured by a fibrosis measurement device commercially available as CUTOMETER® MPA 580 (skin probe), and found to be less than that measured in similar subjects who are not treated with a method of the present technology.

0046The embodiments and the examples described herein are exemplary and not intended to be limiting in describing the full scope of the devices, compositions and methods of the present technology. Equivalent changes, modifications and variations can be made within the scope of the present technology, with substantially similar results.